The Relationship Between Apical Vertebral Rotation and Truncal Rotation in Adolescent Idiopathic Scoliosis Using 3D Reconstructions

2018 ◽  
Vol 6 (3) ◽  
pp. 213-219 ◽  
Author(s):  
Pawel P. Jankowski ◽  
Burt Yaszay ◽  
Krishna R. Cidambi ◽  
Carrie E. Bartley ◽  
Tracey P. Bastrom ◽  
...  
2019 ◽  
Vol 31 (6) ◽  
pp. 873-879
Author(s):  
Chris Labaki ◽  
Joeffroy Otayek ◽  
Abir Massaad ◽  
Ziad Bakouny ◽  
Mohammad Karam ◽  
...  

OBJECTIVEThe aim of this study was to determine if the apical vertebra (AV) in patients with adolescent idiopathic scoliosis (AIS) is the most rotated vertebra in the scoliotic segment.METHODSA total of 158 patients with AIS (Cobb angle range 20°–101°) underwent biplanar radiography with 3D reconstructions of the spine and calculation of vertebral axial rotations. The type of major curvature was recorded (thoracic, thoracolumbar, or lumbar), and both major and minor curvatures were included. The difference of levels (DL) between the level of maximal vertebral rotation (LMVR) and the AV was calculated as follows: DL = 0 if LMVR and AV were the same, DL = 1 if LMVR was directly above or below the AV, and DL = 2 if LMVR was separated by 1 vertebra or more from the AV. To investigate which factors explained the divergence of the LMVR from the AV, multinomial models were computed.RESULTSThe distribution of the DL was as follows: for major curvatures, 143 were DL = 0, 11 were DL = 1, and 4 were DL = 2; and for minor curvatures, 53 were DL = 0, 9 were DL = 1, and 31 were DL = 2. The determinants of a DL = 2 (compared with DL = 0) were lumbar curvature (compared with thoracic; adjusted OR 0.094, p = 0.001), major curvature (compared with minor; adjusted OR 0.116, p = 0.001), and curvatures with increasing apical vertebral rotation (adjusted OR 0.788, p < 0.001).CONCLUSIONSThis study showed that the AV is the most rotated vertebra in the majority of major curvatures, while in minor curvatures, the most rotated vertebra appears to be the junctional vertebra between major and minor curvatures in a significant proportion of cases.


2016 ◽  
Vol 6 (1_suppl) ◽  
pp. s-0036-1583044-s-0036-1583044
Author(s):  
Khalil Kharrat ◽  
Amer Sebaaly ◽  
Ayman Assi ◽  
Ismat Ghanem ◽  
Rami Rachkidi

Author(s):  
X Wang ◽  
CE Aubin ◽  
RM Schwend

The objective was to assess deformity correction and bone-screw force associated respectively with concave manipulation first, convex manipulation first, and different differential rod contouring configurations. Instrumentation scenarios were computationally simulated for 10 AIS cases with mean thoracic Cobb angle (MT) of 54±8°, apical vertebral rotation (AVR) of 19±2° and thoracic kyphosis of 21±9°. Instrumentations with major correction maneuvers using the concave side rod were first simulated; instrumentations with major correction maneuvers using the convex side rod were then simulated. Simulated correction maneuvers were concave/convex rod translation followed by apical vertebral derotation and then convex/concave rod translation. There were no significant differences in deformity corrections and bone-screw forces between concave rod translation first and convex rod translation first with differential rod contouring. Increasing differential rod contouring angle and concave rod diameter improved AVR correction and increased the TK and bone-screw forces; the effect on the MT Cobb angle was not clinically significant.


2007 ◽  
Vol 16 (10) ◽  
pp. 1570-1578 ◽  
Author(s):  
Hannes Behensky ◽  
Ashley A. Cole ◽  
Brian J. C. Freeman ◽  
Michael P. Grevitt ◽  
Hossein S. Mehdian ◽  
...  

2016 ◽  
Vol 41 (3) ◽  
pp. 303-310 ◽  
Author(s):  
Gözde Gür ◽  
Cigdem Ayhan ◽  
Yavuz Yakut

Background: Core stabilization training is used to improve postural balance in musculoskeletal problems. Objectives: The purpose of this study was to investigate the effectiveness of stabilization training in adolescent idiopathic scoliosis. Study design: A randomized controlled trial, pretest–posttest design. Methods: In total, 25 subjects with adolescent idiopathic scoliosis were randomly divided into two groups: stabilization group ( n = 12) and control group ( n = 13). The stabilization group received core stabilization in addition to traditional rehabilitation, and the control group received traditional rehabilitation for 10 weeks. Assessment included Cobb’s angle on radiograph, apical vertebral rotation in Adam’s test, trunk asymmetry (Posterior Trunk Symmetry Index), cosmetic trunk deformity (Trunk Appearance Perception Scale), and quality of life (Scoliosis Research Society-22 questionnaire). Results: Inter-group comparisons showed significantly greater improvements in the mean change in lumbar apical vertebral rotation degree and the pain domain of Scoliosis Research Society-22 in the stabilization group than those in the control group ( p < 0.05). No significant differences were observed for other measurements between the groups; however, trends toward greater improvement were observed in the stabilization group. Conclusion: Core stabilization training in addition to traditional exercises was more effective than traditional exercises alone in the correction of vertebral rotation and reduction of pain in adolescent idiopathic scoliosis. Clinical relevance Stabilization exercises are more effective in reducing rotation deformity and pain than traditional exercises in the conservative rehabilitation of adolescent idiopathic scoliosis. These improvements suggest that stabilization training should be added to rehabilitation programs in adolescent idiopathic scoliosis.


2011 ◽  
Vol 24 (4) ◽  
pp. 251-257 ◽  
Author(s):  
Aliasgar Dalal ◽  
Vidyadhar V. Upasani ◽  
Tracey P. Bastrom ◽  
Burt Yaszay ◽  
Suken A. Shah ◽  
...  

2021 ◽  
Vol 162 (39) ◽  
pp. 1573-1578
Author(s):  
Kristóf József ◽  
István Márkus ◽  
Csaba Bogyó ◽  
Miklós Tunyogi Csapó ◽  
Ádám Tibor Schlégl

Összefoglaló. Bevezetés: Nincs egységesen elfogadott álláspont, hogy a serdülőkori idiopathiás gerincferdülés sebészi korrekcióját melyik életkorban optimális elvégezni. Világszerte 11 éves kortól akár (kezeletlen esetben) 50–60 éves korig végeznek fúziós műtétet a betegségben, 63–83%-os átlagos koronális síkú korrekciós hatékonysággal. Célkitűzés: Célul tűztük ki, hogy felmérjük a gerinckorrekciós műtétek hatékonyságát három dimenzióban, illetve a páciens életkorának függvényében. Módszerek: A vizsgálatba 23, serdülőkori idiopathiás gerincferdüléssel diagnosztizált beteget (12 fő 17 évnél fiatalabb, 11 fő 17 évnél idősebb) vontunk be. Minden betegnél csavaros derotációt és spondylodesist végeztünk, és a beavatkozás előtt és után EOS 2D/3D felvételeket, majd sterEOS 3D rekonstrukciókat készítettünk. A következő paramétereket számítottuk: Cobb-fok, háti kyphosis, ágyéki lordosis, apicalis csigolyarotáció, maximális csigolyarotáció. A különböző életkorú csoportok közötti különbséget kétmintás t-próbával, illetve Wilcoxon-féle próbával vizsgáltuk. Eredmények: A gerinckorrekciós műtétek során a koronális síkú eltérést 78,2%-ban (átlagosan 55,1 Cobb-fokról 12,0 Cobb-fokra), az apicalis csigolyarotációt 56,7%-ban (átlagosan 21,0 fokról 9,1 fokra) tudtuk korrigálni. A 17 éves életkor után operált páciensek esetén átlagosan 79,2%-os Cobb-fok-csökkenést értünk el, míg a fiatalabb betegcsoportban 77,0%-ban korrigáltuk a koronális főgörbületet (p = 0,614). Az idősebb betegcsoportban szignifikánsan kevésbé sikerült az apicalis csigolyarotáció korrekciója (átlagosan 38,1%; 21,8 fokról 12,4 fokra), mint a fiatalabb pácienseknél (átlagosan 68,5%; 20,2 fokról 6,2 fokra; p = 0,016). Következtetés: Összességében a nemzetközi publikációknak megfelelő korrekciót értünk el. A koronális síkban közel azonos korrekciós hatékonyság figyelhető meg a különböző életkorú betegcsoportok között, a csigolyarotáció azonban 17 éves életkor előtt hatékonyabban korrigálható. Orv Hetil. 2021; 162(39): 1573–1578. Summary. Introduction: There is no clear recommendation for the optimal age to perform corrective surgery in adolescent idiopathic scoliosis. Fusion surgery is performed from the age of 11 to 50–60 years, with an average coronal plane correction efficiency of 63–83%. Objective: We aimed to evaluate the effectiveness of correction surgeries in three dimensions in adolescent idiopathic scoliosis. In addition, our objective was to examine the influence of the patient’s age on the correction. Methods: The study included 23 patients with adolescent idiopathic scoliosis (12 patients younger than 17 years, 11 patients older than 17 years). All patients underwent screw-derotation and spondylodesis and underwent EOS 2D/3D imaging before and after the operation, followed by sterEOS 3D reconstructions. The following parameters were calculated: Cobb degree, thoracic kyphosis, lumbar lordosis, apical vertebral rotation, maximal vertebral rotation. Differences between different age groups were examined by paired-sample t-test and Wilcoxon rank sum test. Results: The mean efficiency of correction surgeries was 78.2% in the coronal plane (from an average of 55.1 Cobb degrees to 12.0 Cobb degrees) and 56.7% in the axial plane (from an average of 21.0 degrees to 9.1 degrees). We achieved an average 79.2% reduction of Cobb angle in patients operated after the age of 17 years, which was 77.0% in the younger group (p = 0.614). Apical vertebral rotation correction was significantly less successful in the elderly group (mean 38.1%; from 21.8 degrees to 12.4 degrees) than in patients operated before the age of 17 years (mean 68.5%; from 20.2 degrees to 6.2 degrees; p = 0.016). Conclusion: We achieved scoliosis correction in line with the international publications. Nearly the same correction efficiency was observed between different age groups of patients in the coronal plane. However, vertebral rotation can be derotated more effectively before the age of 17 years. Orv Hetil. 2021; 162(39): 1573–1578.


2003 ◽  
Vol 27 (2) ◽  
pp. 121-131 ◽  
Author(s):  
M. S. Wong ◽  
J. T. C. Lee ◽  
K. D. K. Luk ◽  
L. C. K. Chan

Scoliosis is a threedimensional spinal deformity. Although orthotic treatment for moderate adolescent idiopathic scoliosis (AIS) has been well recognized, there are few studies documenting the effectiveness of different casting methods in the fabrication of thoracolumbosacral orthoses (TLSO). The current study was a retrospective clinical evaluation of the effectiveness of two commonly used casting methods namely, the frame casting method and the supine with traction casting method in the treatment of AIS. Eighty (80) female patients with AIS were recruited and they were all treated by TLSOs. The frame casting method was used in 37 patients while the remaining 43 patients were under the supine with traction casting method. The responses of spinal deformities under the two different casting methods were analyzed for the period from prebrace to 2 years after bracing. The studied parameters included the AP Cobb's angle, the apical vertebral rotation and the trunk listing (cervicosacral lateral offset). The results of the current study showed that the orthoses manufactured from the two casting methods could provide an effective control of AIS (change of Cobb's angle within (±5°). For the frame casting, the Cobb's angles at prebrace and 2 years after offbrace were 36.0° and 33.8° respectively while for the supine with traction casting, the corresponding Cobb's angles were 32.7° and 34.0°. The frame casting method could give a better control of the apical vertebral rotation at the early stage of treatment (prebrace=18.2° and the 4th month=13.8° while the supine with traction casting method was more effective in the longterm control of the trunk listing (prebrace=10mm and 2 years after offbrace=3.3mm).


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